Kaiser Foundation Health Plan of the Mid Atlantic States, INC

Kaiser Foundation Health Plan of the Mid Atlantic States, INC was paid $32K by Medicaid between Jan 2018 and Nov 2024, across 34 billing codes. Its largest line is 0001A, — 38% of everything it billed.

33Billing provider infoKAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
HYATTSVILLE, MD 20785

33aNPI1730254681assigned 11/22/2006

33bProvider typeHealth Maintenance Organization

28Total paid$32K

24GClaims7,129

24DCodes billed34

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Health Maintenance Organization providers in Maryland

Rank by total paid#8 of 8

Median peer was paid$2.92M

This provider vs. median0.0×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	948	$3K
2020	147	$113.79
2021	1,063	$22K
2022	619	$3K
2023	1,517	$1K
2024incomplete	2,835	$3K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
0001A		38%	445	436	$12K
0002A		21%	289	286	$7K
87635	Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe	13%	58	46	$4K
36415	Collection of venous blood by venipuncture	6.2%	1,578	1,273	$2K
80051		2.9%	773	617	$943.52
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r	2.7%	22	18	$869.67
85027		1.8%	427	378	$590.13
82565		1.8%	690	549	$586.06
84520		1.7%	731	590	$539.34
85025	Blood count; complete (CBC), automated, and automated differential WBC count	1.6%	363	305	$527.52
83036	Hemoglobin; glycosylated (A1C)	1.6%	196	186	$508.39
87636	Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B	1.3%	13	12	$435.51

22 more codes

84443	Thyroid stimulating hormone (TSH)	1.3%	137	$431.80
82947		1.1%	598	$362.40
80076		1.1%	197	$347.42
87491	Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe	<1%	69	$181.18
86803		<1%	32	$99.89
86708		<1%	13	$74.34
87340		<1%	14	$72.31
99213	Doctor's office visit, returning patient (routine)	<1%	16	$66.53
82570		<1%	14	$65.78
86706		<1%	14	$62.65
82043		<1%	13	$48.29
87389	Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies	<1%	13	$48.16
80061	Lipid panel	<1%	59	$40.17
81001		<1%	114	$37.99
87591	Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe	<1%	55	$35.09
83721		<1%	57	$31.50
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	28	$27.72
82306	Vitamin D; 25 hydroxy, includes fraction(s), if performed	<1%	34	$25.00
81025		<1%	12	$7.30
S9999	Sales tax	0%	19	$0.00
91300		0%	18	$0.00
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	0%	18	$0.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialSWINTON, COLLEEN (DIRECTOR, CREDENTIALING)

Same official

Other billing entities under SWINTON, COLLEEN

Full network →

Provider	Location	Paid
Kaiser Foundation Health Plan of the Mid Atlantic States, INC	Annapolis, MD	$18K
Kaiser Foundation Health Plan of the Mid Atlantic States, INC	Rockville, MD	$0.00

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.